Thursday, November 28, 2013

One of evolution's most successful designs, to this day it's a feared predator across the planet. Its range covers most of the northern hemisphere. One subspecies, the Yukon Wolf, is the largest living wild canid today. They're ferocious hunters.

What makes Gray Wolves so incredibly successful is their social nature. Their intelligence makes them clever, capable of adapting to new situations and prey. They hunt in packs, which allows them to bring down animals much larger than they individually are. Bison. Moose. Musk Ox. They have an impressive array of teeth and powerful jaw muscles that can crack large bones.

"We have sharp teeth for a reason, Phil. Let's use them."

And, somewhere around 30,000 years ago, this social tendency led to them becoming oddly intertwined with a primate species that was gradually spreading across the planet. A branch off the Gray Wolves became hunting partners, guards, and companions. Each species learning from the other in a remarkably successful relationship that continues to this day.

Still vicious. Still wild. Still... Oh, who am I kidding.

This is the modern wolf. From dangerous hunter to pillow for video-game-playing ape.

Wednesday, November 27, 2013

Everyone's heard of the Titanic, Andrea Doria, and Lusitania. But most shipwrecks are long forgotten, except in the areas they occurred.

Long before The Perfect Storm was made famous by a George Clooney movie, there was the Portland Gale of 1898. The storm was catastrophic, but is mostly forgotten now.

In 48 hours of early-winter gale over 300 ships were either sunk or seriously damaged. Lives lost is unknown, but likely between 500-1000. Shore towns and cities from Massachusetts to Maine were devastated by rain, sleet, and more than 2 feet of snow, driven by winds measured up to 110 miles per hour. Communities of beach cottages simply vanished.

But the storm is still called by the name of it's most prominent victim: the steamship Portland.

In 1898 the Boston, Massachusetts to Portland, Maine route was a busy one, used heavily by both business and leisure travelers. Some took trains, while others preferred steamships. The latter traveled on coastal steamers, usually by night (the equivalent of a "red-eye" flight today). A ticket was $1 to $5, depending on your accomodations. You'd board in the evening, have dinner on the ship, sleep in your cabin, and the next morning were there. The ships went back and forth 3-4 times a week.

The New England weather can be notoriously vicious. A storm was coming in when the Portland sailed on the evening of November 26, 1898. Her captain, Hollis Blanchard, was known for being cautious, but apparently saw nothing in the conditions or forecast that unduly alarmed him. At 7:00 p.m. the ship sailed from India wharf in Boston, never to return.

The ship was sighted by others in the next few hours, but as the storm worsened, eventually vanished in the gale. When and exactly how she foundered will always be a secret, as she took all 192 passengers and crew with her. Recovered watches had all stopped between 9:00 and 10:00, though whether this was a.m. or p.m. is unknown.

The next day wreckage began washing ashore: furniture, timbers, luggage, lifebelts, and lots of bodies. Although the picture above shows a lifeboat being launched, none were ever found, and the severity of the storm makes it unlikely this was even attempted.

Several entire families were lost in the tragedy, traveling home after Thanksgiving in Boston. Their memorials are scattered across New England graveyards. The Portland black community was hit particularly hard, as (except for the officers) the majority of the crew were black men. In 1898 (33 years after the Civil War) service on these ships was considered a very respectable job for a black man, and those who served were generally veterans of the trade, supporting families ashore. They were often more sought after than white men for the same positions, as white men looking for these jobs were younger, less experienced, and seen as more likely to leave the job without notice.

The Portland herself would remain hidden for a long time. In 1989 the wreck was located, but the technology wouldn't allow an accurate identification. So it was forgotten again until 2002, when it was found by side-scan sonar. It's since been explored by divers, though at a depth of 460 feet in very cold water this is limited and dangerous.

If you're interested in learning more about the Portland and gale or 1898, I recommend the book "Four Short Blasts" (the title refers to the whistle distress signal of the time) by Peter Dow Bachelder. The book also has a brief history of the American Life-Saving Service, which eventually became today's U.S. Coast Guard.

Thursday, November 21, 2013

Dr. Grumpy is rude. His staff is rude. His wait time is always over an hour. He's incompetent. He's malicious.

Well, it's hard for me to objectively address most of these charges, but I can say that the longest I've ever kept a patient waiting is 23 minutes.

I hate sites where you can anonymously rate doctors. Anyone can put up a scathing review, even if they didn't actually see you. Maybe they're pissed off that you don't take their insurance, or wouldn't give them the extra 40 Percocets they wanted.

The sites don't check to make sure that they really saw you. For all you know you're being rated by a person angry that your kid beat theirs in the school spelling bee (don't tell me people aren't that petty. They are.). And because we're doctors, we can't really defend ourselves. After all, we took an oath to keep your health concerns in confidence.

Let's look at this the other way: what if I were to create an online public forum where doctors could rate patients by name. Of course, while we'd be encouraged to write only about our own patients, who's to make us do so? What if you're someone who dinged my car at Costco this weekend, or the barista who can never get my order right? I could use the site just for the hell of it.

"Probably a drug seeker. I wouldn't touch her."

"Very whiny and needy. Calls staff all the time."

"Dumb as a rock. Can't remember his meds."

"Argues incessantly about his crappy $15 co-pay".

"Needs to buy a toothbrush and some deodorant."

Best of all, we doctors could put it up anonymously. You'd have absolutely no way to know who wrote it (you could guess). In fact, even if I never saw you, and say, just didn't like you based on meeting you somewhere, I could write whatever I wanted. And you'd have absolutely no legal recourse. Sure, you could post something in your own defense, but, do you have time for that?

Of course, that would never happen. Besides being unethical, it's frankly illegal for a doctor to do that. Patients, however, have a free reign to anonymously say whatever the hell they want about us. Even if they've never actually seen you and are making it all up.

The other problem that affects these rating sites is simply human nature. When something goes well, we expect it and say nothing. But when something goes wrong, we get angry and want the world to know. So the reviews are predominantly written by people pissed-off enough to take the time to find a ratings site, create an account (maybe several), and write one or more bad reviews. The people who thought the doctor was awesome may outnumber them 100 to 1, but won't write anything. So, as in everything else, a small but vocal minority can drown out the truth.

Besides, it's so much more fun to write a bad review than a good one. Most of us learned this in high school, whether through writing a book report, gossiping about others, or reading Perez Hilton.

For these sites, and those who contribute to them, I think we have to keep in mind the words of the finest restaurant critic in history, Mr. Anton Ego:

"In many ways, the work of a critic is easy. We risk very little, yet enjoy a position over those who offer up their work and theirselves to our judgment. We thrive on negative criticism, which is fun to write and to read. But the bitter truth we critics must face, is that in the grand scheme of things, the average piece of junk is more meaningful than our criticism designating it so."

Monday, November 18, 2013

I finally had the time today to fire up the Grumpy family hot tub for the winter.

So I cleaned it out, filled it up, added chemicals, put in a new filter, etc.

For
whatever reason, though, I couldn't find the power cord that comes with
it. Because I'm a guy (and therefore inherently stupid) I just grabbed
an extension cord out of the garage. Mrs. Grumpy kept telling me I
wasn't supposed to do that, because the special hot tub cord had extra
circuits or fuses or breakers or whatever in it, and you couldn't use
something else.

But I wanted to get the hot tub going, so I told her it would be fine, and hooked it up.

The
kids were excited, so I had them out in the yard with me. They counted
down from 10 for me to flip the switch, turning it on for the winter.

"5-4-3-2-1- HOT TUB!". I pressed the button. The jets whirled, the water swirled, the kids laughed.

Thursday, November 14, 2013

When I went to Big State University in the 1980's, I worked in a campus department office.

A girl name Alyssa worked there, too. We did not like each other. No idea what it was, just bad chemistry I guess. The kind of thing where within a few seconds of meeting someone you know you hate them.

We were able to work politely, but everyone in the office knew the temp got colder when we were both in the same room. So we tried to stick with different jobs in the daily routine, and avoid each other.

Until, one day... disaster struck.

That afternoon someone gave us both THE SAME DAMN JOB. Booklets were needed for a meeting of some sort, and we had to put them together. This would likely have gone fine, except for one minor detail: we had to share one freakin' stapler.

It wasn't a standard stapler, either, but one of those heavy-duty office ones designed for thick stuff.

So here we were, each taking page 1 from one pile, page 2 from another, and so on (I think it was around 25 pages total) and stapling them together. As the stapler got shuffled back and forth across the table things got nastier and nastier, with each accusing the other of keeping it for too long, not using it when it was taken, and working too slowly.

At some point we both reached for the stapler at the same time, and began fighting over it. Each of us was trying to staple stuff and not let go of the stapler.

And then, it happened.

All I remember is that we both yelled at the same time, then began swearing. Somehow, we'd stapled ourselves together. The webbing between my right thumb and first finger now impaled through the same area of her left hand.

Blood and paper flew everywhere. Now we were REALLY angry, blaming the other for the accident. And we couldn't get the industrial-grade staple out. There was no option but to walk to student health.

We opened the door and walked out into the main office. People who knew we hated each other, and wondered what the screaming was about, were stunned to see us holding hands. We didn't really have much choice. As blood dripped on the floor she grabbed a box of tissues to staunch things.

We got a few (okay, a lot of) weird looks as we walked across BSU campus to student health. In the waiting room someone told me we looked like a botched suicide pact.

Monday, November 11, 2013

Being a history buff, veterans (especially WW2) are prized patients. I love talking to them and hearing their stories, and it's not uncommon for a guy who served to have to point out to me that's not the reason he came to the doctor.

But one veteran in particular stands out (I've told this story before, but not since 2009).

Bill was a pleasant 90 year-old guy. He was in the first wave at D-Day, and had a shirt full of medals.

By the time I met him, however, he was mildly demented. Macular degeneration and glaucoma had left him blind in one eye with severely impaired vision in the other. His reaction time was terrible.

And, of course, he was still driving. His son brought me pictures of the damage to Bill's car from hitting signs, walls, trees, pedestrians, whatever.

"My son exaggerates, doc. Nothing a little paint won't fix."

Bill stubbornly refused to stop, so I ordered a driving evaluation. Which, of course, he failed miserably. Although it pained me to do it, I filled out the paperwork to revoke his license.

About a week later Bill came in for a follow-up appointment (he took the bus). But he wasn't alone. And my office is pretty small.

He was accompanied by his friends from the local VFW chapter. Like, 8-10 of them. All were well over 80, and wearing their VFW hats.

To my horror, Bill was the only one left in the group who (until recently) hadn't lost his driver's license. As a result, he was their driver. And now he'd lost it, too.

"Give Bill his license back, Dr. Grumpy. You're our only hope"

All gave me glowing testimonials as to what a wonderful driver Bill is, with comments like:

"He almost never hits things."

"It's not his fault traffic lights are outside his visual field."

"Gus's Bar is pretty close, anyway."

"Everyone knows Bill's car, and watches out when they see him coming."

Saturday, November 9, 2013

I got dragged in to do a consult (and I'm not on call!) today. As per tradition, I stopped in the doctor's lounge to grab a Diet Coke on the way up to the floor.

It was the usual Saturday mid-day crowd of surgeons and hospitalists, some at computers, others watching the Saturday college football games.

As I paused to look at the score, some TV announcer chimed in "Be sure to stay with us at halftime. Many Big State University alumni died serving their country in World War II, and BSU invited them to today's game. Nearly 50 were able to be here, and there will be a special Veterans Day tribute by the marching band."

Thursday, November 7, 2013

All the damn time. Every medical journal, CME service, and medical supply company has some such crap. If you order the gold-level service you get an iPad-mini, go with the platinum and you get an iPad. My wife has seen it from companies selling school nurse supplies in bulk

Of course, the iPad isn't really "free." Its cost is figured into whatever they're charging you for the purchase, or they're taking a slight loss hoping to get you as a loyal customer (doesn't work, guys. Ask any pharmacist who's forced to hand out gift cards to people who transfer a prescription).

But I digress.

Anyway, my point here is that pretty much EVERY professional level product is often sold with a "get a free iPad" gimmick.

Including, apparently, rats.

Yes, lab researchers, now you too can get a free iPad with your order of research rodents. Need some transgenic rats to test antibiotics? You've got an iPad-Mini! Doing cancer research on knockout rats? Get an iPad!

Wednesday, November 6, 2013

Mr. Garda: "I guess I did... It must have fallen out at the restaurant last night."

Lady Garda: "For Pete's sake! This is the 5th insurance card you've lost this year! I'm tired of calling them to get you a new one!"

Mr. Garda: "I'm sorry..."

Lady Garda: "You're lucky I carry an extra around for you!" (hands card to Mary) "You're a freakin' policeman! Grumpyville trusts you to carry a loaded gun everywhere, and you can't even keep track of a damn insurance card!"

Saturday, November 2, 2013

Friday, November 1, 2013

"It's not the important things I don't remember. It's the stuff that's important, but not as important as more important stuff. Some stuff, you know, is important and some isn't important important, but still important. So I remember most of the important important stuff, or least the important parts of what's important, but not other important stuff because it's just not as important. I think this is important."

Welcome to my whining!

This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

Singing Foo!

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Dr. Grumpy is for hire! Need an article written (humorous, medical, or otherwise) or want to commission a genuine Grumpy piece for your newspaper/magazine/toilet paper roll? Contact me to discuss subjects. You can reach me at the email address below.

Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.